目的探讨扩散加权成像(DWI)、灌注加权成像(PWI)以及两者联合对幕上毛细胞型星形细胞瘤(PA)与WHO 2级多形性黄色星形细胞瘤(PXA WHO 2级)的鉴别诊断价值。资料与方法回顾性分析2010年1月—2022年2月于福建医科大学附属第一医院经手术和...目的探讨扩散加权成像(DWI)、灌注加权成像(PWI)以及两者联合对幕上毛细胞型星形细胞瘤(PA)与WHO 2级多形性黄色星形细胞瘤(PXA WHO 2级)的鉴别诊断价值。资料与方法回顾性分析2010年1月—2022年2月于福建医科大学附属第一医院经手术和病理证实的23例幕上PA及11例PXA WHO 2级的常规MRI、DWI及PWI资料,并将幕上PA根据病灶部位进一步分为脑叶型PA与非脑叶型PA,对比两组基本资料(性别、年龄、囊变、均匀强化、病灶大小和是否累及脑膜)、最小表观扩散系数、相对表观扩散系数及相对最大脑血容量。结果PXA WHO 2级出现软脑膜受累的概率(36.3%)高于幕上PA(4.3%,P=0.029);PXA WHO 2级分别与幕上PA、脑叶型PA相比,最小表观扩散系数、相对表观扩散系数均较低,相对最大脑血容量较高(t=-4.398~5.828,P均<0.05)。最小表观扩散系数鉴别幕上PA与PXA WHO 2级的阈值为1.09×10^(-3) mm^(2)/s,敏感度、特异度和曲线下面积分别为90.91%、83.33%和0.947;当相对最大脑血容量的鉴别诊断阈值为1.79时,敏感度、特异度和曲线下面积分别为90.00%、100.00%和0.950。DWI联合PWI的曲线下面积为0.993,与单独使用DWI及PWI对比,均未提高诊断效能(Z=1.371、0.928,P均>0.05)。亚组分析中,脑叶型PA与PXA中DWI联合PWI的曲线下面积为0.988,分别与DWI及PWI对比,均未提高诊断效能(Z=1.322、0.882,P均>0.05)。结论DWI、PWI均有助于PXA WHO 2级与幕上PA、脑叶型PA的鉴别诊断,但DWI联合PWI未显著提高鉴别诊断效能。展开更多
Background: The irrational use of medicines remains a key health problem in many developing countries. The overuse of antibiotics is a key driver of antimicrobial resistance (AMR). This study surveyed antibiotic use a...Background: The irrational use of medicines remains a key health problem in many developing countries. The overuse of antibiotics is a key driver of antimicrobial resistance (AMR). This study surveyed antibiotic use and adherence to the World Health Organization (WHO) prescribing indicators at the Request Muntanga Hospital in the Kalomo District of Southern Province, Zambia. Materials and Methods: This cross-sectional study was conducted from July 2023 to September 2023 at Request Muntanga Hospital in Zambia and reviewed 600 medical record prescriptions which were issued from July 1, 2022 to June 30, 2023 using the WHO prescribing indicators. The collected data were analyzed using Statistical Package for Social Sciences version 23.0. Results: From the 600 prescriptions sampled, 1246 medicines were prescribed, with antibiotics making up 86.7% of the encounters. Additionally, the average number of drugs prescribed per encounter was 2.1 and the prevalence of polypharmacy was 61.3%. Further, 17.8% of medicines were prescribed as injectables. Furthermore, 76.7% of the drugs were prescribed from the Zambia Essential Medicines List and 38.9% by generic names. Conclusions: This study found a high use of antibiotics and deviations from the WHO/International Network of Rational Use of Drugs (INRUD) core prescribing indicators at the Request Muntanga Hospital indicating non-adherence to the prescribing indicators. There is a need to promote adherence to the WHO/INRUD core prescribing indicators to promote the rational use of antibiotics and prevent the emergence and spread of AMR.展开更多
文摘目的探讨扩散加权成像(DWI)、灌注加权成像(PWI)以及两者联合对幕上毛细胞型星形细胞瘤(PA)与WHO 2级多形性黄色星形细胞瘤(PXA WHO 2级)的鉴别诊断价值。资料与方法回顾性分析2010年1月—2022年2月于福建医科大学附属第一医院经手术和病理证实的23例幕上PA及11例PXA WHO 2级的常规MRI、DWI及PWI资料,并将幕上PA根据病灶部位进一步分为脑叶型PA与非脑叶型PA,对比两组基本资料(性别、年龄、囊变、均匀强化、病灶大小和是否累及脑膜)、最小表观扩散系数、相对表观扩散系数及相对最大脑血容量。结果PXA WHO 2级出现软脑膜受累的概率(36.3%)高于幕上PA(4.3%,P=0.029);PXA WHO 2级分别与幕上PA、脑叶型PA相比,最小表观扩散系数、相对表观扩散系数均较低,相对最大脑血容量较高(t=-4.398~5.828,P均<0.05)。最小表观扩散系数鉴别幕上PA与PXA WHO 2级的阈值为1.09×10^(-3) mm^(2)/s,敏感度、特异度和曲线下面积分别为90.91%、83.33%和0.947;当相对最大脑血容量的鉴别诊断阈值为1.79时,敏感度、特异度和曲线下面积分别为90.00%、100.00%和0.950。DWI联合PWI的曲线下面积为0.993,与单独使用DWI及PWI对比,均未提高诊断效能(Z=1.371、0.928,P均>0.05)。亚组分析中,脑叶型PA与PXA中DWI联合PWI的曲线下面积为0.988,分别与DWI及PWI对比,均未提高诊断效能(Z=1.322、0.882,P均>0.05)。结论DWI、PWI均有助于PXA WHO 2级与幕上PA、脑叶型PA的鉴别诊断,但DWI联合PWI未显著提高鉴别诊断效能。
文摘Background: The irrational use of medicines remains a key health problem in many developing countries. The overuse of antibiotics is a key driver of antimicrobial resistance (AMR). This study surveyed antibiotic use and adherence to the World Health Organization (WHO) prescribing indicators at the Request Muntanga Hospital in the Kalomo District of Southern Province, Zambia. Materials and Methods: This cross-sectional study was conducted from July 2023 to September 2023 at Request Muntanga Hospital in Zambia and reviewed 600 medical record prescriptions which were issued from July 1, 2022 to June 30, 2023 using the WHO prescribing indicators. The collected data were analyzed using Statistical Package for Social Sciences version 23.0. Results: From the 600 prescriptions sampled, 1246 medicines were prescribed, with antibiotics making up 86.7% of the encounters. Additionally, the average number of drugs prescribed per encounter was 2.1 and the prevalence of polypharmacy was 61.3%. Further, 17.8% of medicines were prescribed as injectables. Furthermore, 76.7% of the drugs were prescribed from the Zambia Essential Medicines List and 38.9% by generic names. Conclusions: This study found a high use of antibiotics and deviations from the WHO/International Network of Rational Use of Drugs (INRUD) core prescribing indicators at the Request Muntanga Hospital indicating non-adherence to the prescribing indicators. There is a need to promote adherence to the WHO/INRUD core prescribing indicators to promote the rational use of antibiotics and prevent the emergence and spread of AMR.
